Chest Wall Disorder: Pectus Excavatum

What Is Pectus Excavatum?

Pectus excavatum is a genetic deformity of the chest wall that causes several ribs and the breastbone (sternum) to grow abnormally.

Usually, the ribs and sternum go outward at the front of the chest. With pectus excavatum, the sternum goes inward to form a depression in the chest. This gives the chest a concave (caved-in) appearance, which is why the condition is also called funnel chest or sunken chest.

How Is Pectus Excavatum Treated?

In some cases, surgery can treat pectus excavatum. In the Ravitch procedure, a surgeon removes damaged cartilage, repairs or reshapes the sternum, and places a bar (or bars) in the chest wall to hold it in the proper position. The bar will be removed in a later surgery, usually after about 6 months. This surgery is typically used for patients 13 to 22 years old.

A more recent technique, the Nuss procedure, is less invasive. The surgeon inserts a curved metal bar through a small incision to push out the chest. A stabilizer bar is added to keep it in place. The chest is permanently reshaped in 2–4 years and both bars are surgically removed. The Nuss procedure can be used with patients age 9 and older.

Looking Ahead

Mild pectus excavatum won't need treatment if it doesn't affect how the lungs or heart work. But when the condition is very noticeable or causes health problems, a person's self-image can suffer. In those cases, treatment can improve a child's physical and emotional well-being.

Most kids and teens who have surgery do very well and are happy with the results.